ali's african adventures

The community on board the ship here is just that: a community. It's like a small town, complete with a Town Square, a post office, a hairdresser and a school for the children in the twenty or so families who call this place home. One of my favourite parts about life here is that I get to serve as a youth leader with the junior high and high school-age kids on board. We meet every Tuesday for worship, study, service and fun.

Tonight was service. We split into groups and headed down to the wards to have dance parties, paint fingernails and do crafts with the patients. Those of you who know me well might be surprised to hear that I was not, in fact, part of the dance party group. Working ten-hour days while pregnant isn't exactly a picnic, especially since it turns out that everything they ever told me about the second trimester was a nasty lie. At least for me. I'm more tired now than ever, probably related to the fact that my body still continues to staunchly reject all food except for elbow macaroni, cheese and cereal. (I manage the occasional BLT, but we only get bacon once a week, so that's not much extra protein.)

So I volunteered to lead the craft group and two of the girls and I gathered supplies and headed to D Ward where I knew there were a few kids who would be eager to get their hands on some glue sticks. It's a craft I've done before here and one I've done with kids at home in New Jersey, too, at the church where my sister teaches the kids. The message is simple: You are fearfully and wonderfully made.

We gave them each a stripe-less paper zebra and a handful of multi-coloured strips of paper, and before they set to work gluing, I had them each look around the room at the people gathered there. Boys and girls and mamas and papas. Brown and white and tall and short. Bandages covering necks and eyes, tubes coming from noses, scars distorting cheerful smiles. Each one different. Each one marked by life in some way, each one on a different part of the road towards healing. Each one beautiful, created by a loving God.

We had four kids lined up on the blanket on the floor and twice as many adults gathered to listen. Paul, one of our new day volunteers, translated while the children sat quietly, nodding solemnly each time he said it again. You are beautiful. No matter how you look, He has made you beautiful.

They bent their bandaged heads to their work, each one choosing a different pattern for his zebra.

Edem lined all his stripes up perfectly, covering every square inch of his paper canvas. He's seven and had surgery six days ago to remove a massive tumor that was distorting the side of his face, pushing his eye out and threatening his sight. Before the operation, he could barely see from his right eye, and we were afraid that the surgery would damage his sight irreparably. This morning, we removed the bandage and he carefully held his little hand over his good eye as his nurse shone a light towards the bad one. I could see his head snap up when he realized that he could see that light. Emboldened, he slowly opened the swollen eye and proudly answered correctly every time his mama held up fingers for him to count. Across the room, my eyes filled with tears as I realized that I was witnessing a quiet miracle, right there in the corner of D Ward.

Kossi chose a more haphazard placement for his stripes, which kind of surprised me, since he's the studious one of the bunch. He's around the same age as Edem and also had surgery on a tumour in his cheek. He spends much of his time sitting on a stool a the end of his bed, feet swinging, looking through picture books or colouring carefully inside the lines. He'll go back to the operating room tomorrow to have the packing taken out of his nose, and he should be able to go home soon.

Aichatou is eleven and the surgery to transplant a piece of her rib to replace a damaged jaw joint has been successful, but the wound has been slow to close. Her therapy consists of chewing gum to exercise the mouth she hasn't opened for most of her short life, and her favourite kind is Juicy Fruit. She has a sweet, quiet smile and her zebra was carefully patterned in criss-crossing stripes.

Moukaela was the last in the line, his zebra receiving stripes on top of stripes on top of stripes. His little eyes widened each time he reached into the bucket to pick out a new one, amazed that he was allowed to just keep going even when his whole zebra was covered. Moukaela is well known to us, at least in the outpatient department. He was seen for stubborn wounds from noma throughout the whole outreach last time we were here in Togo, but we were never able to do his surgery because he just wouldn't heal. His name is the first on the list on tomorrow's schedule, and he'll have the first of several operations to rebuild his mouth.

Beautiful, each one of them. We sat there on that blanket, helping little hands glue stripes on zebras and we spoke this truth over each of their lives.

You are beautiful.

Yesterday was Ash Wednesday, the first day of Lent. I didn't grow up celebrating the season of Lent. Easter just kind of snuck up on me every year, the Sunday when we woke up extra-early for the sunrise service at the Chapel followed by a potluck breakfast in the church basement. Here on the ship, we come from so many different traditions, and so we end up celebrating many facets of the Christian faith that were unfamiliar to me before I came here. Lent is one of them.

As a community, we're going through a set of readings by Henri Nouwen, and I shared the first one at handover yesterday morning, surrounded by day volunteers and nurses and a ward full of max-fax patients, each of them recovering from or waiting for surgeries to repair and rebuild their faces.

In Bed Ten, Toyi slept quietly, the caregiver from the next bed over holding vigil at the foot of the bed, ready to translate if we needed to speak to Toyi in his obscure tribal language, Kabiye. Toyi is over sixty years old, and sometime when he was a child, he fell victim to noma, a simple infection that ravages the faces of the poor. It kills ninety percent of its victims and leaves the rest in various stages of disfigurement. Toyi lost his nose and part of his left cheek, a wide scar stretching across his face under his eyes that refused to meet ours when he was admitted.

On Tuesday, Toyi had the same surgery as Tani did two years ago, the first in a series of operations to create a nose from a flap of skin pulled from his forehead. A man who has lived a lifetime on the fringes, unable to find a way to feel human, now has a nose that covers the hole in the middle of his face.

It was Toyi that made me cry as I read Nouwen's words yesterday as he wrote about the journey of Lent.

But maybe all of this is the other side of a deep mystery, the mystery that we have no lasting dwelling place on this earth and that only God loves us the way we desire to be loved. Maybe all these small rejections are reminders that I am a traveler on the way to a sacred place where God holds me in the palm of His hand.

Our patients walk such a long road, from the time they're first aware that they're different to the day they walk up the gangway. They settle into their beds down on Deck Three, fear and hope vying for the upper hand in their eyes as we search for a way to walk alongside them.

We are all travelers in one way or another. We all start out so far from God, so far from the knowledge that He is so much closer to us than our own heartbeats. Some have father to walk than others; I have no way of understanding the life of rejection that Toyi has suffered until now, but I do know that, for this short time, our roads have become one.

It will be three weeks before Toyi's second surgery and another couple after that before he's fully healed. Maybe sometime around Easter he'll be ready to go home, and I can only hope and pray that his journey here during this time will be one that leads him to that sacred place where God holds him in the palm of His hand.

Today, at the end of a long week, my heart is light. Coming back to a country that we visited only two years ago means that we have the chance to do further surgeries on patients we weren't finished with back in 2010. We have two of them on the wards right now, Noelie and Venant. Both needed another operation to remove the tumors that have started to regrow in their faces; Noelie had her surgery yesterday, and Venant is still waiting until we can get his blood pressure a little lower.

This afternoon, I got an e-mail from the screening team letting me know that another patient would be returning on Sunday to attend the plastic surgery screening on Monday. She'd be coming from far up country, so she'd need to stay overnight since she doesn't have any family here in Lomé. When I saw her name, I immediately left word with the team that I wanted to be paged when she arrived.

That page came sooner than I thought it would, and right before dinner I ran back down to D Ward to see Tani. She's a child who was burned at a very young age, losing her top lip, her nose, her right ear and eye and all the fingers on one of her hands. Back in 2010 we started the process of rebuilding her face, using skin from other parts of her body to create a nose and a top lip.



(This is an old photo of her from while she was still healing back in 2010; I can't wait for you to see how good she looks now!)

She was with us on the wards for fifty-six days while her wounds healed, and we came to love her. A lot.

Her eyes lit up when she saw me, and we sat together on the floor while she ate her dinner, leaning up against me like no time had passed. A translator sat with us while I chatted with her caregiver, a friend of her village pastor. (This is what community looks like. The pastor came as her caregiver last time, since he was the only one available who spoke enough French to be able to translate for her obscure tribal language. This time, yet another unrelated man has come all these hours to sleep under Tani's bed and care for her until she is well.) I caught up on the news from the village while Tani twisted around to smile up at me.

She's taller now, much more grown up, but she's still Tani, and it's pure joy to see her again. Her face has healed beautifully, her scars all smoothed out with the passing of time. The plastic surgeon, Dr. Tertius, arrives tonight, and he'll see her on Monday along with all the rest of the hopeful plastics patients. I'll let you know as soon as I know how her story will continue to unfold.

It's good to be back in Togo.

There's much I could say about the wards, but I'm going to step back from hospital stories for a minute and talk about the other most important thing in my life at the moment: the baby! I expect posting from here on in to be a mix of the two subjects, but I'll do my best not to skimp on the ward stories.

A lot of people have asked me what it's like being pregnant on a ship. Short answer? Not terribly fun.

Morning sickness hit at five weeks for me, and by 'morning' I mean 'all day long and throughout the night with no hope of relief.' While this might have been manageable at home with access to lots of different kinds of food and fresh air in which to exercise, it's a completely different matter on a ship. Which is in constant (albeit slight) motion. With a communal dining room. In a port that smells like rotten fish.

For the last nine weeks, just walking into the dining room has been an exercise in, well, I'm not sure what you call an exercise in which you breathe through your mouth and pray not to vomit in front of all your friends. Whatever that's called. This baby (who we've nicknamed Poppy since he or she was the size of a poppy seed when we first found out I was pregnant) has decided that I should only be allowed to regularly consume five things: elbow macaroni, grilled cheese, baked potatoes, applesauce, and vanilla yogurt. Since the galley routinely cooks anything but these things, it's been difficult to keep myself nourished. Add to that a couple of pretty strong cravings, and it should become fairly obvious that I've become obsessed with food. And not in a good way.

The galley chefs were pretty much the first ones to know that Poppy was on the way, because they're the ones that have been keeping me fed, supplying me with baked potatoes, big bags of elbow macaroni and meals specially cooked with me in mind. The guys in the ship shop have responded to my after-hours calls for spaghetti sauce and yogurt, keeping my fridge well stocked. When pizza tempts my fancy, other friends bring me some back when they go out to dinner. I've been surrounded by people who go out of their way to make sure I have the things I need.

Now, it's one thing to have access to a list of the five things that you can eat. It's another to be provided with your very random, very specific, very unavailable-in-Africa cravings. I have had three of them: a sweet onion chicken teriyaki sandwich from Subway, a bagel with cream cheese, and my mother's homemade granola. The closest Subway (and my mother for that matter) are thousands of miles away, and while cream cheese does exist here in Togo, I've never ever seen a bagel. And yet here I was, stuck on a ship and wanting these specific things so badly that I'm not too proud to admit that it brought me to tears. More than once.

And this is where God steps in.



That, my friends, is what a Subway sandwich looks like after surviving a cross-Atlantic journey shoved in the bottom of a dear friend's carry-on bag. And also falling on the ground. I took that picture in my very own cabin here on the ship, proof that miracles do come true. I danced in the hallway when the bag was placed in my hands and almost didn't make it back to the couch before I tore into it. That sandwich tasted like heaven to me. That is not an exaggeration.

Fast forward a few weeks when I saw one of my patients eating some snack crackers with cream cheese. I jokingly turned to her nurse and told her that I was willing to fight that small child for the cream cheese, as long as someone could provide me a bagel to put it on. Threatening to mug a small child; I am officially a crazy pregnant lady. I left the ward to attend our daily staffing meeting, and we were all sitting crammed into my boss' office when I heard a voice in the hall. Does anyone want a bagel? My friend Heather had just happened to bake bagels, just happened to walk past our meeting with a bowl of them, still warm from the oven, and one of the other team leaders just happened to have a package of cream cheese in her fridge that she was willing to donate to me.

I cried embarrassingly hard in front of the rest of the team. And then I ate my bagel. And the two others that Heather left with the HoJ for me later that day. I have no photographic evidence of this because by the time I thought of it, I had inhaled all but about two bites. You're going to have to take my word for it, but they were amazing.

The last craving, the granola, was one I had given up on, because there's just no good way to get freshly baked granola from my mother's kitchen to my cabin. I knew that it was impossible, and I figured two out of three was a pretty good record. I was e-mailing with Ines, a former ship mum who I've stayed in contact with after their family had to leave. She mentioned that friends of theirs were coming to the ship soon, and would I like anything from Germany? I jokingly mentioned a few ridiculous things (Subway is one thing; carting strawberries across international borders isn't always legal), and then she said something I was never in a million years expecting.

I'm making homemade granola today. I make it maybe once or twice a year. Do you want some of that? Cue the tears. (It's a bit disturbing, really, to realize just how often I cry these days.) The bag arrived a couple days ago, and just smelling it was satisfying. It's the closest thing to my mother's recipe that I've ever tasted, and for the first time ever I've been happy to get up for breakfast since it means I can mix some in with my honey nut cheerios, close my eyes, and pretend I'm home again.



And this is proof to me. Proof that God cares about the little things just as much as he cares about the big ones. Ines said something in an e-mail about how she understands why God cares about our patients, for the ones cast aside and suffering cruelly because of their diseases and deformities. But, amazingly, He cares just as much for me and my small desires.

I could have survived this pregnancy just fine with nothing but elbow macaroni and grilled cheese. Heck, I've hit my stride with the start of this second trimester and I'm going for a new world record of Days in a Row Without Vomiting; I'm up to six now. It may have felt like the longest nine weeks of my life, but I would have been totally fine without my Subway and my bagel and my granola.

But God loves me, and He loves Poppy. And so He provided, more than I could ask or imagine He provided. Sometimes He shows up in miraculous healings, in lives pulled back from the edge of despair. And sometimes he shows up in a homemade bagel or a Subway sandwich or a bag of granola.

I'm learning to see Him in all these places.

It's Saturday. The first full week of surgery for the year is finished, and somehow we all made it through. It's been a busy start by any standards, with three max-fax surgeons all operating at once, and given my current state of constant exhaustion I've been spending most of my time just keeping my head above water.

Sometimes my job here can become just that: a job. That's more true than ever these days when it's all I can do to make it through rounds every morning. All three surgeons took on difficult cases, and the max-fax patients quickly spilled out of D Ward and into the domain of nurses who haven't had the same amount of training in our specialty. Add that to a team of brand new nurses and the inevitable ironing out of kinks that comes with starting over in a new country, and it's no wonder that I've found it hard to see more than just the tasks in front of me.

Yesterday, close to the end of my shift, the OR called for their next patient, a man who we originally operated on in Benin back in 2008. The tumor in his jaw has started to grow back, and so he needed to have a second painful surgery, a second long recovery. His nurse was still on orientation and had never brought a patient to the OR, so she asked me to walk her through the process. I gladly agreed and we worked through the pre-operative checklist together, collected his bag of IV fluids and made the short walk down the hallway to the bench that serves as the waiting area.

We went through the checklist a second time with the OR nurse, and when we asked if he had any last-minute questions, his response was quick. God will take care of me. I am ready. We bowed our heads, laid our hands on his shoulders and prayed for him, and as he disappeared through the door, his nurse collected his flip flops and we turned to go back to the ward.

When I realized she wasn't following me, I turned back to find her leaning against the wall, tears filling her eyes. That's the first one, she told me. That's the first time I've seen that part.

I looked over at the worn, wooden bench, the same bench that stood outside the operating rooms on the Anastasis. Every patient who has ever received surgery on either ship has sat on that bench, been prayed for before they walk through the doors and into the promise of their new life.

It's not just a job. That new nurse reminded me of that yesterday as we stood together in the hallway and cried. It's not just a series of tasks to be completed, a list of things to be checked off before I can come back to my cabin and rest. Stacia, one of the other team leaders, calls the hospital hallway the Hallway of Hope, and she told me yesterday that she cries for joy every single time she brings a patient down it to sit on that bench.

I love this time of year. I love how the new nurses are seeing all this through fresh eyes, experiencing for the first time everything that I got to experience for the first time four years ago. I only have fourteen more weeks before I have to leave the ship and head home for the rest of my pregnancy, and I think I'll take in every single moment between now and then.

Stay tuned for more stories. I already have a few, and it's only been a week.

A disclaimer before I begin: this post has nothing to do with either the hospital or the baby. But I can't help being excited and sharing this!

I grew up going to a small church in New Jersey. We all sat in exactly the same seats every single Sunday morning, everyone knew everyone else, and there were connections all over the place. My high school Sunday School teachers were my dad and my dentist. The guy who taught the middle school class was the principal of my middle school. His son, Stephen Collucci, is who I'm writing about.

Food and Wine magazine just announced that they're searching for The People's Best New Pastry Chef. The honour will be given to one of fifty nominees from all over the country, and Stephen is up for the award!



He's the pastry chef at Colicchio & Sons in New York City, and I just went onto their website and realized that their Tap Room is high on my list of places to visit once I'm home for maternity leave. (Sister - fancy a trip into the city?)

I know that most of you don't know Stephen (except for all of you back at TRBC!), but please take a minute to go onto the Food and Wine website and vote for him. You don't have to register or anything; it's just a simple click of a button.

Here's hoping I see a familiar face in a famous magazine soon!

Wednesday was screening day at the local stadium here in Lomé. It's the one day of the year where we see as many potential patients as possible and schedule as many surgeries as possible for the upcoming field service.

The first teams left the ship on Tuesday evening to stay overnight and manage the people who would come to get in line the night before. For those of us who come from countries where medical care is easily accessible, the thought of waiting overnight to see a doctor isn't something we can really understand. But here in West Africa, this is the reality.

I was in the second wave of Land Rovers to leave the ship, and we pulled up to the station in the early dawn. The line stretched out as far as I could see, people dressed in every colour of the rainbow, waiting patiently under the watchful eyes of the local gendarmes.



When the jobs for screening were originally handed out, I was assigned to a pre-screening station just inside the main gate. However, this little baby of ours is not the most cooperative kid. I've been pretty sick ever since I hit five weeks, and standing all day in the heat wasn't really going to be an option for me. Instead of pre-screening, I ended up at the opposite end of the process, the final check table, comfortably situated in a breezy piece of shade.



Somewhere around 3,500 people came to the stadium in hopes that they would be chosen. They came with their hopes and their fears, and so many of them had to be turned away. 1,600 were allowed through the gates, and every single one of these were seen by the teams inside. Some were given dates for surgery, others were given cards to come back to be seen by physicians and surgeons on the ship before we could make a final decision. And some were escorted directly to a huddle of chairs under the spreading boughs of a huge tree where a team sat waiting to pray with the ones we had to turn away.



My table was the last stop before the exit, and throughout the course of the day I saw every single person who was given a yellow card. Those yellow cards are the golden tickets, the passes that get them through the port gate and onto the ship to be seen. My job for the day was to collect paperwork and check that each person sitting across from me knew when to come back to the ship and what would happen that day. That was it. Just make sure that the ones chosen knew when to come for their chance at life.

Usually at screening I'm the one saying no. I have to see the hope in their eyes and I have to be the one to snuff that slight flame. It's so easy to feel hopeless on that side, to feel crushed by the weight of the pain and the need here in West Africa. But on Wednesday I couldn't stop smiling. I was finally able to see how much we can do instead of how much we leave undone.



A few times, I saw patients who I had taken care of last time we were here in Togo, in 2010. They had brought sons and mothers and friends to be seen and when we recognized each other, there were invariably hugs and dance parties. I saw one little boy who was being seen in the outpatients department during the entire 2010 field service. We were never able to do his surgery because of stubborn wounds that just wouldn't heal. To be quite honest, I never expected to see him alive again, and when his mama slipped her arms around me and told me c'est fini, I couldn't help crying just a little. He has a card to come for screening with the plastic surgeon when he gets here, and we see no reason that he won't be scheduled this year.

The first patients will be admitted on Sunday afternoon, and the first surgeries will be on Monday. Please pray for our patients, for the new nurses who will be learning the ropes in the upcoming weeks, for the empty spots still on the staffing plans. We will be here in Togo until June, and there is much to be done in such a short time.

(All photos courtesy of the fabulous Mercy Ships communications department.)